This text-based course is a transcript of the webinar, “Multidimensional Goals & Objectives for Children Who Stutter,” presented by E. Charles Healey, Ph.D. CCC-SLP, BCS-FD.
>> Charles Healey: Thank you for allowing me to provide some information about setting goals and objective for children who stutter from a multidimensional point of view. How many of you are speech language pathologists working in the schools? Most of what I am going to talk about today is related to how IEP goals and objectives are written, but certainly those who are in different clinical settings could incorporate many of the principles that I will talk about, if not on paper, in the form of a conceptualization of how we are going to view the treatment of children who stutter.
A Conceptual Framework about Stuttering Relative to Setting Goals for Treatment
Let’s start with the conceptual framework that I work from to get us on the same page in terms of how we are going to view stuttering. Most people who view stuttering from a uni-dimensional perspective, believe that we are only working with the fluency aspect of the disorder, meaning we are working on reducing or eliminating the sound/syllable repetitions or the sound prolongations, the struggle behavior, the stuttering severity, etc. that the child is doing to disrupt the forward flow of speech. Most of us, who are fluency specialists and those who work with a lot of people who stutter, realize that there is more to stuttering than just the stuttering itself. There are many factors that contribute to why a child may be more fluent in one situation and less fluent in another. Again as we know from working with children who stutter, it waxes and wanes; some days are good days and some days are bad days. With some people that the child talks to, you may see a dramatic reduction in stuttering, and in others, you see a dramatic increase. In that respect, we need to look at more of a multi-dimensional approach to this problem such that we are looking at every child who stutters and every adult who stutters, stutters in a different way. They come with different histories; they come with different perspectives and ideas about why they stutter, and their stuttering is impacted by who they are talking to, at what time, in what situation, how they are feeling, and what they are trying to say. We need to take that into account.
Many children who stutter have concomitant disorders along with the stuttering, such as ADHD, a learning disability, language disorder, multiple articulation errors, and other things. That was documented in a study that a graduate student and I did several years ago where we found that approximately 40% of the children who were identified by state criteria had stuttering plus language and articulation disorders. They are certainly out there and that is something that we also need to take into consideration when we are treating the problem.